Provider Demographics
NPI:1396045522
Name:SPRING MINOR CARE LLC
Entity Type:Organization
Organization Name:SPRING MINOR CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TANYA
Authorized Official - Middle Name:
Authorized Official - Last Name:CISNEROS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-621-4464
Mailing Address - Street 1:6300 RICHMOND AVE
Mailing Address - Street 2:SUITE 333
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77057-5931
Mailing Address - Country:US
Mailing Address - Phone:713-621-4464
Mailing Address - Fax:713-621-7775
Practice Address - Street 1:1136 GRAND AVE
Practice Address - Street 2:
Practice Address - City:BACLIFF
Practice Address - State:TX
Practice Address - Zip Code:77518-2760
Practice Address - Country:US
Practice Address - Phone:713-621-4464
Practice Address - Fax:713-624-7775
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-21
Last Update Date:2010-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care